Nowadays, schizophrenia is considered to be a spectrum of disorders rather than a single disorder, but it has been publicly misperceived as a type of mental illness that causes the mind to “split,” which is a rough translation of the term from Greek (“Schizophrenia & Dissociative Disorders”). The term, as well as an early definition of the disorder, was introduced by Eugen Bleuler (Maatz et al. 43). Before him, the illness was distinguished by Kraepelin, who termed it as “dementia praecox.” However, Bleuler highlighted the fact that schizophrenia is hardly related to dementia and used the new word to denote the way in which the illness splits (damages) human functioning (Maatz et al. 44). In other words, the term has never referred to multiple personality disorder.
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To sum up, the diagnosis first appeared in the 1910s, and the term was first coined in 1908 by Bleuler (Maatz et al. 45). Since then, the disorder has been studied to a greater extent, but throughout its history, schizophrenia has been related to misconceptions and stigma in various settings, including those of mental institutions (“Schizophrenia & Dissociative Disorders”). Apart from that, there are multiple factors that are still unknown about the disorder, including its mechanisms and causes (“Schizophrenia diagnosis”). As a result, the history of the diagnosis is still to be developed.
Currently, schizophrenia spectrum disorders (SSD) cannot be diagnosed with the help of any laboratory tests or scanning, but certain tests, including MRI and urinalysis, can be used to determine certain potential causes or symptoms (“Schizophrenia diagnosis”). The process of diagnosing involves a comprehensive assessment of the patient’s symptoms, in which a specialist searches for the symptoms of schizophrenia and other disorders, which need to be ruled out for the diagnosis to be made (“How is Schizophrenia Diagnosed – Four Patients”). The information on the symptoms is obtained from clinical interviews as well as other people who may be aware of the patient’s behavior, and the guidance is provided by the Diagnostic and Statistical Manual of Mental Disorders (DSM), which is continually updated by the American Psychiatric Association (“How Schizophrenia Is Diagnosed”). Schizophrenia is usually diagnosed in patients in their twenties, and it was first diagnosed in the 1910s (Maatz et al. 45; “Schizophrenia & Dissociative Disorders”).
The specific symptoms of SSD include positive and negative ones (“How Schizophrenia Is Diagnosed”). The former refers to the presence of psychotic symptoms (delusions, hallucinations, disorganized speech and behaviors), and the latter presupposes a lack of normal behaviors and responses (for example, the flat affect). Positive symptoms are particularly important: for schizophrenia to be diagnosed, the patient must exhibit either delusions, hallucinations, or disorganized speech in addition to at least one other positive or negative symptom (American Psychiatric Association 99). Apart from that, SSD can manifest itself in the way it affects cognitive abilities (for example, memory), which can be discovered with the help of special tests (“Шизофрения”). However, the cognitive effects are not necessary to diagnose the disorder.
It is also noteworthy that SSD is only diagnosed in case the symptoms are present for at least six months; otherwise, another disorder is likely to be diagnosed. For example, bipolar disorder with psychotic features, which is important and sometimes difficult to differentiate from schizophrenia, is diagnosed in case the symptoms are present for at least one month and occur during a mood episode (American Psychiatric Association 96). In the case of SSD, the symptoms are not supposed to coincide with mood episodes, must be present for at least six months, and can be found in prodromal, acute, and residual stages of the disorder (American Psychiatric Association 99).
Indeed, SSD can be misdiagnosed. Apart from a variety of psychotic disorders, which share its symptoms, schizophrenia of the prodromal state may resemble depressive disorders (“Шизофрения”). Apart from that, brain tumors are known to cause symptoms similar to those of schizophrenia (“How Schizophrenia Is Diagnosed”). The specific guidelines for differential diagnoses can be found in DSM.
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders; DSM-5. 5th ed., American Psychiatric Publishing, 2013.
“How is Schizophrenia Diagnosed – Four Patients.” YouTube, uploaded by Bogdan Paul, 2013, YouTube.
“How Schizophrenia Is Diagnosed.” YouTube, uploaded by Howcast, 2013, YouTube.
Maatz, Anke, et al. “Eugen Bleuler’s Schizophrenia—A Modern Perspective.” Dialogues in Clinical Neuroscience, vol. 17, no. 1, 2015, pp. 43-49.
“Schizophrenia Diagnosis.” YouTube, uploaded by khanacademymedicine, 2015, YouTube.
“Schizophrenia & Dissociative Disorders: Crash Course Psychology #32.” YouTube, uploaded by CrashCourse, 2014, YouTube.
“Шизофрения – Причины, Симптомы, Диагностика, Лечение и Патология.” YouTube, uploaded by осмос, 2016, YouTube.